Sesame
Allergy Facts, Symptoms, and Treatment

Also known as benne, sesame is an erect plant typically grown for its seeds, which are rich in protein, thiamin, and vitamin B6. These seeds are used as food and flavorings and employed to create sesame oil, which is found in margarine and shortening, utilized as a cooking or salad oil, and employed in the manufacture of pharmaceuticals, lubricants, cosmetics, and soaps. Meanwhile, foods containing whole sesame seeds are eaten extensively in the Middle East and Asia, and in North America and Europe, they're sometimes used to flavor and garnish foods such as breads and other baked goods.1 In addition, sesame is eaten as a paste called tahini and a dessert named halva.2

Sesame allergy prevalence varies geographically and is common in Israel, Japan, and Europe.3 In fact, sesame is reported as the second most common food to cause anaphylaxis in Israeli children. That said, self-reported sesame allergy in the United States and Canada ranges from an estimated 0.1 to 0.2 percent of the population.2 Sesame allergy can begin in childhood or adulthood, but in 80 percent of childhood onset sesame allergy, the condition will persist into adulthood. Those who outgrow the allergy usually do so by the age of 6.4

Where is sesame found?

Sesame seeds and oil are common food ingredients around the world. In addition, sesame is often found in spice blends and flavorings, but since recipes for these items are often proprietary, sesame may not be listed on all ingredient labels involving spices.7 Because sesame seeds are often used atop bread, other baked goods, and salads, there is a risk of cross-contamination, particularly in bakeries and at deli and salad counters. What's more, the seeds often develop a static charge and cling to surfaces such as other foods and clothing, furthering the risk of cross-contamination.4

Foods that may contain sesame include:7 Asian cuisine, baked goods (e.g., bagels, bread, hamburger buns, rolls), breadcrumbs, cereals (e.g., granola, muesli), chips (e.g., bagel, pita, tortilla), crackers (e.g., melba toast, sesame snap bars), dipping sauces (e.g., baba ghanoush, hummus, tahini sauce), dressings, falafel, flavored rice and noodles, gravies, goma-dofu (sesame tofu), herbs and herbal drinks, hummus, margarine, marinades, pasteli (sesame seed candy), processed meats and sausages, protein and energy bars, sauces, snack foods (e.g., pretzels, candy, halvah, rice cakes), shish kebabs, stews, stir fries, soups, sushi, tempeh, Turkish cake, and vegetarian burgers.

In addition, the following ingredients may indicate the presence of sesame and should be avoided by allergic individuals:7 benne, benne seed, benniseed, gingelly, gingelly oil, gomasio (sesame salt), sesame flour, sesame paste, sesame salt, sesamol, sesamum indicum, sesemolina, sim, tahini, tahina, tehina, and til.

Nonfood products that also may contain sesame include cosmetics (such as soaps and creams), medications, and nutritional supplements.7

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Are there other allergens I could be sensitized to?*

Some people with sesame allergy may also experience symptoms when eating other seemingly unrelated foods. This is called cross-reactivity and occurs when your body's immune system identifies the proteins, or components, in different substances as being structurally similar or biologically related, thus triggering a response. The most common cross-reactivities with sesame are other seeds, tree nuts, and peanuts.8

Knowing the proteins, or components, within each allergen that may be triggering your symptoms can help guide your management plan. With that in mind, and based on your symptom history, your healthcare provider may suggest something called a specific IgE allergen component test, which can help reveal which proteins you are sensitized to.

Already have your specific IgE allergen component test results?

Your test results will include the name of the component (a series of letters and numbers and/or name). Your healthcare provider will likely review the results with you, but here you'll find an at-a-glance breakdown you can use as a reference.

rSes i 1

  • Usually associated with a higher risk for severe reactions or anaphylaxis.13
  • Stable to heat and digestion.14
  • Major protein of sesame and associated with true clinical sesame allergy.15-20

Test results should be interpreted by your healthcare provider in the context of your clinical history. Final diagnosis and decision on further management is made by your healthcare provider.

*These products may not be approved for clinical use in your country. Please work with your healthcare provider to understand availability.

Do I need to avoid all forms of sesame?

The allergenicity of sesame isn't destroyed by heating, so those allergic to sesame must avoid both cooked and uncooked versions of it.4

How do I manage my allergy?

Because there is no cure for food allergies, your healthcare provider may recommend a plan that includes the following.4, 9-12

  • Stay particularly wary in environments prone to cross-contamination, such as bakeries and delis.
  • Read ingredient labels and "may contain" advisory panels on food and nonfood products carefully, and avoid all foods and products containing any form of the allergen. Note that these lists and panels may not appear on the same side of a product's packaging and that manufacturers frequently change ingredients. If you're unable to obtain a list of ingredients, it's safest to avoid that item.
  • Avoid cross-contamination when cooking by using two sets of cooking and eating utensils, with one exclusively for the allergic individual. Wash all dishes and utensils in hot soapy water between uses.
  • Craft an action plan with a list of steps for you and others to take should you accidentally ingest the allergen. Print out a copy of the plan and carry it with you.
  • Talk with restaurant chefs about your allergy and order food that's simply prepared and void of any form of the allergen. Avoid desserts, as they often contain or have come into contact with food allergens.
  • Plan ahead for traveling to ensure your food allergy will be managed and any emergency medication is always available.
  • Wear a medical ID bracelet identifying the allergen to which you're allergic.
  • Carry any recommended or emergency medication with you at all times.
  • Teach children with food allergies which foods to avoid. Work with caregivers and school staff to eliminate or reduce exposure to the allergen and to ensure they understand when and how to use medication to treat symptoms.

Your healthcare provider may direct you to take one of the following medications:

  • Epinephrine auto-injector when there are signs of an acute severe event, aka anaphylaxis (see below). Ensure your family members know how to administer it in case of an emergency.
  • Antihistamines as a supplement may be useful in relieving mild symptoms (e.g., itch); however, they do not halt the progression of an allergic reaction.
  • Bronchodilator (albuterol) as a supplemental therapy for respiratory symptoms, especially in those with a history of bronchospasm or asthma.

If you're with someone who's having an allergic reaction and shows signs of shock, act fast. Look for pale, cool, and clammy skin; a weak, rapid pulse; trouble breathing; confusion; and loss of consciousness. Do the following immediately:

  • Call local emergency services.
  • Ensure the affected individual is lying down with legs elevated.
  • Administer epinephrine immediately for any obvious signs of anaphylaxis.
  • Check the affected individual's pulse and breathing and administer CPR or other first-aid measures if necessary.

Looking for more allergy info and management tips?

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Sesame Allergen Facts, Symptoms, and Treatment

Common Symptoms

Sesame allergy can range from mild to severe and may vary over time, resulting in mild symptoms during one episode and severe symptoms in another. Although food allergy symptoms can start a few minutes to several hours after ingestion, most begin within two hours.5 Symptoms may involve the skin, gastrointestinal tract, cardiovascular system, and respiratory tract, and may include one or more of the following:5,6

  • Abdominal pain, diarrhea, nausea, vomiting, stomach cramps
  • Hives (allergic urticaria), itching, eczema
  • Wheezing, nasal congestion, shortness of breath, repetitive cough
  • Shock, circulatory collapse
  • Tight, hoarse throat, trouble swallowing
  • Pale or blue skin coloring
  • Dizziness, lightheadedness, fainting, weak pulse

Sesame allergy symptoms can also include anaphylaxis, a whole-body reaction that can impair breathing, cause a dramatic drop in blood pressure, and affect heart rate. The most severe allergic reaction, anaphylaxis can come on within minutes of exposure and can be fatal.5

How do I know if I'm allergic?*

Together with your symptom history, skin-prick testing or specific IgE blood testing can help determine if you are allergic to a particular allergen. If you are diagnosed with an allergy, your healthcare provider will work with you to create a management plan.

*These products may not be approved for clinical use in your country. Please work with your healthcare provider to understand availability.

Is there a risk for a severe event?

Because food allergic reactions are unpredictable and symptoms range from local to systemic, it is recommended that an epinephrine prescription be considered for any patient with an IgE-mediated food allergy.10

If you have asthma, you may face a higher risk of severe sesame reactions, particularly if your asthma is poorly controlled.4

  1. Encyclopedia Britannica [Internet]. Chicago: Encyclopedia Britannica Inc.; 2020 Apr 12. Disponível em: https://www.britannica.com/plant/sesame-plant.
  2. Adatia A, Clarke AE, Yanishevsky Y, Ben-Shoshan M. Sesame allergy: current perspectives. J Asthma Allergy. 2017 Apr 27;10:141-151. doi: 10.2147/JAA.S113612. PMID: 28490893; PMCID: PMC5414576.
  3. Permaul P, Stutius LM, Sheehan WJ, Rangsithienchai P, Walter JE, Twarog FJ, Young MC, Scott JE, Schneider LC, Phipatanakul W. Sesame allergy: role of specific IgE and skin-prick testing in predicting food challenge results. Allergy Asthma Proc. 2009 Nov-Dec;30(6):643-8. doi: 10.2500/aap.2009.30.3294. PMID: 20031010; PMCID: PMC3131114.
  4. The Anaphylaxis Campaign [Internet]. Farnborough, UK: The Anaphylaxis Campaign; 2019 Nov. Disponível em: https://www.anaphylaxis.org.uk/wp-content/uploads/2019/11/Sesame-2019.pdf.
  5. American College of Allergy, Asthma & Immunology [Internet]. Arlington Heights, IL: American College of Allergy, Asthma & Immunology; 2014. Disponível em: https://acaai.org/allergies/types/food-allergy.
  6. Mayo Clinic [Internet]. Rochester, MN: Mayo Foundation for Medical Education and Research; 2019 Nov 2. Disponível em: https://www.mayoclinic.org/diseases-conditions/food-allergy/symptoms-causes/syc-20355095.
  7. Food Allergy Research & Education [Internet]. McLean, VA: Food Allergy Research & Education; 2020. Disponível em: https://www.foodallergy.org/living-food-allergies/food-allergy-essentials/common-allergens/sesame.
  8. EAACI, et al. Molecular allergology user’s guide. Pediatr Allergy Immunol. 2016 May;27 Suppl 23:1-250. doi: 10.1111/pai.12563. PMID: 27288833. Disponível em: http://www.eaaci.org/documents/Molecular_Allergology-web.pdf
  9. Wright BL, Walkner M, Vickery BP, Gupta RS. Clinical Management of Food Allergy. Pediatr Clin North Am. 2015 Dec;62(6):1409-24. doi: 10.1016/j.pcl.2015.07.012. Epub 2015 Sep 7. PMID: 26456440; PMCID: PMC4960977
  10. American College of Allergy, Asthma & Immunology [Internet]. Arlington Heights, IL: American College of Allergy, Asthma & Immunology; 2014. Disponível em: https://acaai.org/allergies/types-allergies/food-allergy/food-allergy-avoidance.
  11. Harvard Health Publishing [Internet]. Boston, MA: Harvard Medical School; 2020. Disponível em: https://www.health.harvard.edu/healthbeat/6-tips-for-managing-food-allergies.
  12. Mayo Clinic [Internet]. Rochester, MN: Mayo Foundation for Medical Education and Research; 2019 Sep 14. Disponível em: https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468.
  13. Adatia A, Clarke AE, Yanishevsky Y, Ben-Shoshan M. Sesame allergy: current perspectives. J Asthma Allergy. 2017;10:141-51.
  14. Pastorello EA, Varin E, Farioli L, Pravettoni V, Ortolani C, Trambaioli C et al. The major allergen of sesame seeds (Sesamum indicum) is a 2S albumin. J Chromatogr B Biomed Sci Appl. 2001;756(1-2):85-93.
  15. Warren CM, Chadha AS, Sicherer SH, Jiang J, Gupta RS. Prevalence and Severity of Sesame Allergy in the United States. JAMA Netw Open. 2019;2(8).e199144.
  16. Maruyama N, Nakagawa T, Ito K, Cabanos C, Borres MP, Movérare R et al. Measurement of specific IgE antibodies to Ses i 1 improves the diagnosis of sesame allergy. Clin Exp Allergy. 2016;46(1):163-71.
  17. Yanagida N, Ejiri Y, Takeishi D, Sato S, Maruyama N, Takahashi K et al. Ses i 1-specific IgE and sesame oral food challenge results. J Allergy Clin Immunol Pract. 2019;7(6):2084-86.
  18. Saf S, Sifers TM, Baker MG, Warren CM, Knight C, Bakhl K et al. Diagnosis of Sesame Allergy: Analysis of Current Practice and Exploration of Sesame Component Ses i 1. J Allergy Clin Immunol Pract. 2020;8(5):1681-88.
  19. Goldberg MR, Appel MY, Nachshon L, Holmqvist M, Epstein-Rigbi N, Levy MB et al. Combinatorial advantage of Ses i 1-specific IgE and Basophil Activation for diagnosis of Sesame Food Allergy. Pediatr Allergy Immunol. 2021 May 5. doi: 10.1111/pai.13533. Online ahead of print.
  20. Nachshon L, Goldberg MR, Levy MB, Appel MY, Epstein-Rigbi N, Lidholm J, et al. Efficacy and Safety of Sesame Oral Immunotherapy – A Real-World, Single-Center Study. J Allergy Clin Immunol Pract. 2019;7:2775-81.
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